Longitudinal metabolomics insights into feeding patterns, overweight/obesity, and atopic diseases from birth to childhood

Background: During early childhood, significant changes occur, including shifts in dietary patterns, accelerated growth, and the emergence of overweight and allergic diseases. However, a longitudinal metabolomic analysis from birth to childhood for the relationships between these factors remains lacking. Methods: A total of 144 children, who completed a 5-year follow-up from a birth cohort, were enrolled. Time series analysis of urinary metabolites collected at ages 1 and 6 months, and at 1, 3, and 5 years was conducted using ¹H nuclear magnetic resonance (NMR) spectroscopy with partial least squares discriminant analysis (PLS-DA). Identified metabolites were studied in relation to changes over time and associations with breastfeeding patterns, allergen sensitizations, overweight/obesity, and atopic diseases during childhood. Results: C-means clustering identified three distinct modules of metabolite abundance patterns, highlighting an increase in amino acid and a decrease in carbohydrate metabolism across ages. The Bray–Curtis dissimilarity indices of metabolic profiles increased with age, showing lower indices in formula-fed infants and children with overweight/obesity, but a higher index in atopic diseases during childhood. Metabolites differentially expressed between breastfeeding patterns were primarily identified within the first year of life, particularly in relation to milk sensitization at age 1. Venn diagrams illustrated metabolite distributions, showing an 80% overlap between breastfeeding patterns and infant overweight/obesity, and a 53% overlap between overweight/obesity and atopic diseases in childhood. Conclusion: Longitudinal metabolomics analysis revealed associations between gut microbiota-related metabolites and feeding patterns, linking formula feeding to infant overweight/obesity, as well as connections between overweight/obese children and atopic diseases during childhood.